Article 28 of the Dutch civil code requires that transgender people take hormone therapy and undergo surgery to alter their bodies to comport with the gender they wish to present as. Such a course of action is neither medically necessary nor always desired for those dealing with gender identity issues or a formal diagnosis of Gender Identity Disorder. The law also says trans citizens must be permanently and irreversibly sterilized before they can have their gender legally recognized on official documents.

While many countries did at the time adopt similar laws in dealing with trans people who wanted to change how they are identified on official records, many European countries like Portugal and the United Kingdom have since abandoned the surgical and hormonal treatment requirement. Forced sterilization continues to be a cause for concern in many countries however.

“The Dutch law causes anguish for trans people who have not had the required surgery,” said Boris Dittrich, advocacy director in the Lesbian, Gay, Bisexual, and Transgender (LGBT) Rights Program at Human Rights Watch. “Their documents do not match their deeply felt gender identity. This leads to frequent public humiliation, vulnerability to discrimination, and great difficulty finding or holding a job.”

Human Rights Watch interviewed 28 transgender people for the report, as well as medical professionals, legal experts, government officials, representatives of nongovernmental organizations, and academics.

One transgender person interviewed by Human Rights Watch said about the law: “People are left dangling in between two worlds for far longer than is necessary. It is needlessly traumatizing for people who are already very vulnerable.”

Another person summed up the objections to article 28 this way: “The state should stay out of our underwear.”

Trans citizen’s rights to personal freedom and what is known as “physical integrity” are protected by the Dutch constitution, and by several international human rights instruments including the European Convention on Human Rights.

Human Rights Watch is calling on the Netherlands to revise the law immediately, and also to safeguard the right of trans citizens to self-identify — a right that at the moment is subject to a judge’s interpretation of current law. The group also cites that the Netherlands has frequently said that it will change the law, most recently in March of this year, but no action has been forthcoming.

“Trans people are tired of waiting and hearing empty promises,” Dittrich is quoted as saying. ” They want legal action now. Before any new law goes into effect, a lot of time will have passed. Meanwhile trans people have to cope with daily humiliation, discrimination, and frustration.”

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Annmari - like Pam W. said, the "down there" surgery is expensive. It's not necessarily a matter of wanting to keep the old equipment, but rather not being able to afford to have it changed.

There are also those who choose to keep their old equipment, as they feel they are neither fully male nor fully female, and this addresses that in a physical manner. This is one reason that Lilithe M. points out the fluidity of gender - gender really is a spectrum, not just a pink/blue binary.

Annmari...it often has something to do with expense--the genital modification is very complicated, painful and time-consuming. The obvious changes/outward transformation is often more important than the "down there" surgery.

OK. Don't get me wrong. I'm all for people wanting to undergo gender changing surgery. I have no problems with transgender people. When I grew up, in my teens, I knew three transgenders, two females to males and one male to female.

But. I only have a little bit of confusing thoughts here. If you want to change into the gender you believe you belong to, why do you want to keep your old equipment? I mean, confusing as it may seem to some, it only ads to the misunderstandings when we get people like the "pregnant man" gallivanting around the Internet!

If I wanted to change my gender (which I don't) I wouldn't want to keep anything reminding me of what I used to be!

Gender reassignment is not necessarily an either or situation. Gender fluidity is becoming more prominent (again), I think it is a beautiful thing. Forcing people to hurry up and pick a side is still being stuck in the Pink and Blue Brigade. So many other cultures have celebrated the one who walks between two worlds, and they were considered sacred, shamans of the tribes or cultures they belonged to. The discomfort (ahem, Ginger) with the many manifestations of sexuality in the animal kingdom (anybody ever read up on Leopard Slugs?) is a silly patriarchal human way of looking at things. Get over it. Celebrate diversity.

Hi Dont be so very ignorant, and divorced from reality Benny P, how can they "leave to be happy somewhere else" without appropriate documents Or Jenn C, this is just about having basic ID documents such as passports and birth certificates, which is the duty of all governments. I am surprised at some of the strange comments here, on this subject some of you, need to get real, instead of just telling us your unreasonable personal feelings. Is this site Care2 or couldnt care less? At least we know where we stand, and can see right through, all the the trendy liberals.

For those of you wondering, a male-to-female transsexual who has undergone hormone therapy for any significant amount of time (6+ months, roughly) is sterile. The combination of the estrogen and the anti-androgens (testosterone suppressants) will cause the sperm count to drop to the point it would take a miracle to get a cisgender female pregnant.

I don't know if hormone therapy in female-to-males does the same thing for egg production. That may still take a hysterectomy.

There are some insurance plans that cover reassignment surgery, but not many. MtF costs (in the US) approximately $20-30K, plus hospital. (For FtM, add another "0".) Other places in the world, not so much, but you still have to be able to afford to get there and stay there for a while - you don't have a major surgery like this and expect to be able to hop on a plane and survive a 12 hour (or more) flight back home the next day. Reassignment surgery is for the wealthy, and the fit. The rest of us present ourselves, full-time, in the target gender and try to get along with the fact that we still have the old equipment down there. And we're not likely to show it off in public. In my case, "not likely to" = "will never". It isn't anyone's business except mine, my partner's, and my doctor's.